The development of adolescents’ coping in response to stress is critical for adaptive functioning; these coping strategies may be shaped by numerous environmental factors during childhood, including experiences such as exposure to trauma. Childhood trauma has been shown to undermine contemporaneous coping, but how does a history of exposure to trauma and the characteristics of that trauma (type, timing, and accumulation) relate to current coping among adolescents? We addressed this question using a nationally-representative sample of 9427 adolescents (ages 13–18; 48.9% female; 66% White). Adolescents reported on their lifetime exposure to 18 different traumas, including witnessing or experiencing interpersonal violence, accidents, disasters, and violent or accidental loss of loved ones, as well as their current use of coping behaviors when under stress (problem-focused, positive emotion-focused, and negative emotion-focused coping strategies). The study’s results highlight that exposure to nearly all forms of trauma was unrelated to problem-focused and positive emotion-focused coping behaviors, but strongly associated with increased negative emotion-focused coping. Use of each coping style did not vary with age at first exposure to trauma, but increased with the number of lifetime traumatic events experienced. The findings suggest that the extent of prior exposure to trauma, including variations across type and timing, may be related to a particular form of coping that has been linked to increased risk for mental health problems. Study results highlight coping strategies as a potential target for prevention and treatment efforts, and indicate a need to better understand the malleability and trajectory of coping responses to stress for promoting healthy youth development.
School psychologists and counselors with large caseloads struggle with delivery of high‐quality mental health services in the school setting due to time constraints and competing responsibilities. These providers can benefit from technology solutions that help engage and monitor the mental health of their clients in and out of session. This study assessed the usability and acceptability of a mobile health (mHealth) for the mental health technology platform, NeuroFlow, with seven students and three providers in an urban, high school counseling center. Student perceptions of usability and acceptability were gathered via questionnaire while provider perceptions of NeuroFlow were assessed using focus groups. Providers and students reported variable experiences with usability of the platform, but both groups expressed satisfaction with the use of NeuroFlow, demonstrating the acceptability of this approach. Overall, findings revealed that providers and students indicated NeuroFlow could be integrated into mental health treatment but would benefit from increased emphasis on initial and sustained training on the platform features. Further study is needed to examine the extent to which technology‐based applications may support mental health treatment delivered in the school setting.
Objective: Failure to thrive/faltering growth (FTT/FG) is often multiply determined and involves caregiver adherence to various recommendations to optimize child weight gain.The current study at an interdisciplinary FTT/FG clinic (a) documented the taxonomy of treatment recommendations made for children with FTT/FG (Study 1) and (b) developed an adherence measure, which was used by trained clinicians to examine the relationship between adherence and weight gain (Study 2). Methods: In Study 1, all treatment recommendations made to caregivers of 102 children with FTT/FG were recorded and categorized into domains. Based on domains identified in Study 1, a seven-domain adherence measure was developed. Using a new sample in Study 2 (n = 131, aged 1 to 10 years), clinicians assessed caregiver adherence to recommendations made at the prior clinic visit and examined the association between adherence and weight gain. Results: From Study 1, clinic recommendations fell within seven domains, including the following four that were expected to be associated with weight gain: liquids, food, behavior, and meal structure. Study 2 found that caregiver adherence, overall, was generally high (M = 3.0, SD = .80, rated on a 0 to 4 scale). Greater overall adherence was associated with greater weight gain (r = .253, p = .02). Examining specific recommendations, adherence to using high-calorie add-ons and limiting long mealtimes were associated with greater weight gain. Conclusions: The adherence measure developed in this study can be used to assist clinicians in the management of FTT/FG. Future research is needed to further identify specific treatment recommendations whose adherence is most closely associated with children's weight gain. Implications for Impact StatementFailure to thrive/faltering growth (FTT/FG), is complex as clinical presentations may vary depending on the child, with a universal goal of increasing weight and growth. Understanding the role of caregiver adherence to recommendations from interdisciplinary providers for FTT/FG has not been explored in the extant literature, and this study developed an adherence measure for this population in an interdisciplinary clinic setting. Overall adherence and adherence to several specific recommendations were significantly associated with greater weight gain, demonstrating a novel application of adherence assessment for children with FTT/FG.
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